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Early Infant Diagnosis using DBS: highlighting challenges

Early Infant Diagnosis using DBS: highlighting challenges. Denis Tindyebwa Director Pediatric Care and Treatment Elizabeth Glaser Pediatric AIDS Foundation. EID Reaching children “missed” by PMTCT. Identifying and testing exposed infant. Only 10-50% PMCTC sites offer EID services

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Early Infant Diagnosis using DBS: highlighting challenges

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  1. Early Infant Diagnosis using DBS: highlighting challenges Denis Tindyebwa Director Pediatric Care and Treatment Elizabeth Glaser Pediatric AIDS Foundation

  2. EID Reaching children “missed” by PMTCT

  3. Identifying and testing exposed infant • Only 10-50% PMCTC sites offer EID services • Less than 50% exposed children tested • Less than 20% of PMTCT mothers linked to tested infants • Average age at 1st DBS is over 6 months – only 40% tested within 3 months • Very few exposed children identified in MCH, Ped wards, OPD • Going beyond specimen collection and checking basic clinical parameters – weight, etc

  4. Taking specimens - DBS • Who orders the test, now & later • Clear simple SOPs • No of staff able to take specimen; • Task shifting? • Quality of specimens; • Feedback to sites on quality of specimen

  5. Going beyond doing PCR testing • 10% exposed children started on CTX within 8 weeks • 35% infants receiving results never enrolled in care • 54% Infants enrolled in care not started on ART

  6. DBS PCR Cascade July 08 –April 2009

  7. Conclusion • Implementation of EID requires an integrated approach • Planning and program implementation should always keep focus on intended outcome • Newer technologies; simpler, cheaper better

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